First broadcast on Four Corners on ABC TV on 18 February 2010, A Good Death follows four Australians coming to the end of their lives and the health care professionals who care for them.

Links are included to the a downloadable video link, further resources, a program transcript and an online forum.

Courtesy Four Corners, ABC TV

Australian & New Zealand Society of Palliative Medicine (ANZSPM) is the specialty medical society that facilitates professional development and support for its members and promotes the practice of palliative medicine to improve the quality of care of patients with life threatening illnesses and support for their families.

ANZSPM supports trainees, conducts CPD activities such as functions, conferences and workshops, and provides specialist advice and support to other organisations.

The Centre for Palliative Care Research and Education (CPCRE) was established by Queensland Health in 2001 to enhance palliative care services in Queensland through education and research endeavours.

CPCRE  is led by a consortium of organisations who work with other agencies to improve the quality of care provided to people with a life limiting illness.

The site contains links to information and resources including:

The mission of International Association for Hospice & Palliative Care is to collaborate and work to improve the quality of life of patients with advanced life-threatening conditions and their families, by advancing hospice and palliative care programs, education, research, and favorable policies around the world.

The website provides links to a range of tools and resources for health professionals to utilise, including:

• Administrative and Program Development Tools
• Assessment and Research Tools
• Educational Resources
• Global Palliative Care
• IAHPC List of Essential Medicines for Palliative Care
• Information for Patients/Relatives
• Pain Relief and Palliative Care as Human Rights Documents
• Policy and Advocacy Tools
• Standards for Palliative Care
• Treatment Guidelines

Journeys – Palliative care for children and teenagers is an information resource which aims to better prepare and equip families and carers for the many situations and issues they may face as they live with their child’s illness. It is a starting point in identifying where to look or who to go to for specific information and support which best meets their needs.

Journeys is specially designed in four modular sections, each containing a resource list relevant to the different stages of the journey. These lists contain telephone contact numbers, websites and other references such as books. The modular design of this resource allows families to approach each section of their journey when they feel they are ready.

Sections include:

• Introduction
• Getting Ready
• On the Road
• The Next Leg

Multilingual informatiuon and consumer fact sheets developed by Palliative Care Australia (PCA) regarding palliative care, morphine and questions to ask. Available in the following languages:

• Arabic 
• Chinese - simplified 
• Croatian
• Dari
• Farsi
• French 
• Greek 
• Italian 
• Japanese 
• Khmer 
• Korean
• Macedonian 
• Maltese 
• Polish 
• Portuguese 
• Russian 
• Serbian
• Spanish
• Traditional Chinese 
• Turkish 
• Vietnamese 

Palliative Care Australia has developed the National Palliative Care Service Directory to assist the community and health professionals access information about palliative care services, primary care services providing care at the end of life and a range of other services providing support to people with life limiting illness.

Palliative Care Australia has designed the search function to enable specific searches by members of the community including patients and carers and health professionals.

Children with conditions that are life limiting are living longer due to advances in medical care so the need for palliative care is greater. A recent report by the Department of Health found there is a lack of understanding about what palliative care for children involves, with a general assumption that it only involves care at the end of life.1 This module aims to provide general practitioners with an overview of palliative care for children and young people, to help them in their role of supporting children and their families through this difficult time.

After completing this module you should:

• Have a basic understanding of what paediatric palliative care involves
• Understand the role of emergency healthcare plans/personal resuscitation plans in the care of children and young people with life limiting or life threatening conditions
• Understand how to approach sensitive discussions with parents
• Recognise the importance of the child death review process
• Know which organisations can offer support to parents who are bereaved.

The first truly interdisciplinary book on supportive oncology and palliative care returns with a new edition that serves as a practical guide to the management of the myriad symptoms and quality-of-life issues that occur in patients with cancer--including newly diagnosed patients, patients undergoing treatment, cancer survivors, and patients whose disease is no longer curable.

The interdisciplinary group of contributors includes leading experts in hospice care and palliative medicine, oncology, nursing, neurology, psychiatry, anesthesiology, and pharmacology.

This completely revised edition features new chapters on caregiver stress, hepatic failure, pulmonary failure, research issues in palliative care, and beginning a palliative care program.

Content has been aligned with the needs of today‘s palliative care fellowship programs and includes additional tables, algorithms, and flow charts and is a practical guide to the management of the myriad symptoms and quality-of-life issues that occur in patients with cancer.

A repository of end-of-life care tools including clinical care tools, evaluation tools, education tools and organisational tools developed or adapted by Promoting Excellence in End-of-Life Care demonstration projects.

The resources can also be downloaded by topic.

Also known as the Aboriginal and Torres Strait Islander Peoples Palliative Care Resource Kit, this publication provides strategies and training material to support staff in mainstream health services to provide culturally appropriate palliative care to Aboriginal and Torres Strait Islander peoples.

Expertly developed and empirically validated searches on palliative care topics enable users to upload and run the selected search in PubMed, an online database of articles from medical journals maintained by the National Library of Medicine. This enables real-time identification of relevant literature and evidence on over 50 topics of importance within palliative care.

A fundamental barrier in the quality of care at the end of life is the lack of measurement tools. These measurement tools should identify opportunities for improving medical care, examining the impact of interventions or demonstration programs, and holding institutions accountable for their quality of care. The Toolkit takes steps toward crossing this measurement barrier by creating patient-focused, family-centered survey instruments that address the needs and concerns of patients and their families, as defined by them.

With funding from the Nathan Cummings Foundation and the Robert Wood Johnson Foundation, Brown Medical School has assembled an authoritative bibliography of instruments to measure the quality of care and quality of life for dying patients and their families.

The Western Australian Centre for Cancer and Palliative Care (WACCPC) is a collaboration between Curtin University and Edith Cowan University.

Research strengths of the WACCPC focus on ten key areas:

• Aged care
• Cancer care
• Palliative care
• Paediatric cancer and palliative care
• Primary care
• The impact of cancer, chronic and terminal illness on the family
• Symptom assessment and management
• Instrument development and testing
• Psychosocial oncology
• Care of individuals and families living with non-malignant terminal illnesses

Most people in Australia die in institutionalised care, even though overwhelmingly they want to be at home.

“Bringing Our Dying Home - Creating Community at End of Life” is the newly-released report examining  home-based end of life care, following a two-year study of primary carers, support networks and HOME Hospice community mentors undertaken by the University of Western Sydney and the Cancer Council NSW. 

Innovations in End-of-Life Care was an international, online journal features peer-reviewed promising practices in end-of-life care, useful tools, selected bibliographies, and other resources.

Previously published bimonthly, as of October 2003, the journal will no longer post new issues. All 28 past thematic issues, from January 1999 through September 2003, are now archived at this site and are available to read, download, and print for free.

Articles can be searched by topic, disease themes, measures, patient groups, author or chronologically.

Launched during 2011 Palliative Care week, Life, Hope and Reality is an online resource that provides supportive care information for people with advanced cancer, their families, caregivers and friends. The resource was developed following extensive consultation with researchers, palliative care workers, psychologists, oncologists, surgeons and social workers from institutions across Australia, as well as feedback from patients, their partners, caregivers and the frontline healthcare workers who assist people with the challenges of having an advanced cancer.

Life, Hope and Reality is a practical, up-to-date holistic, best practice guide that includes useful assessment tools, to help people to make health and treatment decisions which are right for them and ensure they receive quality end of life care. 

Sections include:

• Physical Needs
• Emotional Needs
• Social Needs
• Lifestyle
• Finances
• End of Life
• The People Who Care
• Palliative Care
• Useful Assessment Tools 
• Glossary 

Authored by Dr Peter Kaye MA, MB, MRCP, MRCGP, DRCOG, Consultant in Palliative Medicine for Oxford Regional Health Authority and Medical Director of Cynthia Spencer House, Northhampton, England, and first published in 1989, this book is regarded as a vital resource on practical symptom control and patient and family support during illness; and a quick reference for all professionals working with the dying and bereaved.

The book  can be ordered and purchased for $35.00 or printed by chapter, each of which details the principles of symptom control and the management of specific symptoms in palliative care settings 

Other hospice and palliative care books are also available on the site.

In November 2010 the Australian Health Ministers’ Conference endorsed the National Palliative Care Strategy. The Strategy is the policy document that the Australian Government and State and Territory governments use to guide palliative care policy development and service delivery across Australia.

The Strategy has four goal areas:

Awareness and Understanding

• To significantly improve the appreciation of dying and death as a normal part of the life continuum.
• To enhance community and professional awareness of the scope of, and benefits of timely and appropriate access to palliative care services.

Appropriateness and Effectiveness

• Appropriate and effective palliative care is available to all Australians based on need.

Leadership and Governance

• To support the collaborative, proactive, effective governance of national palliative care strategies, resources and approaches.

Capacity and Capability

• To build and enhance the capacity of all relevant sectors in health and human services to provide quality palliative care.

An information sheet that provides a brief overview of the many ways palliative care and palliative treatment services can help people with advanced cancer.

Developed by D. Canning, P. Yates and J.P Rosenberg' at QUT, this framework provides a set of competency standards for specialist palliative care nursing practice in Australia.

Standards are included for each of the following domains:

• Therapeutic Relations
• Complex Supportive Care
• Collaborative Practice
• Leadership
• Improving Practice

Information regarding supportive care options to assist cancer patients before, during and after treatment and dealing with acute and long term side effects of treatment.

The information is written in two formats, one for patients and the other for health professionals.

Topics covered include anxiety, depression, fatigue, reproductive issues and pain management.

Information is also available regarding symptom management, including techniques to assist with effects such as menopause, hair loss, nausea, fatigue and lymphodema.

Downloadable clinical practice guidelines developed and endorsed by NCCN for palliative care professionals.

The Grampians Regional Palliative Care Team works closely with the Palliative Care Service Providers across Victoria to assist in the ongoing development and delivery of effective community based palliative care services. This includes elements of education, collaborative strategic planning, preparation of written materials, policies and procedures, quality improvement processes, and consultation. The Grampians Regional Palliative Care Team is committed to providing a variety of quality education to a broad range of health professionals who are striving for better palliative care practice.

Clinical practice guidelines and policies have been developed for the following topics that can be downloaded in PDF:

• Clinical Guidelines for the Administration of Oral Chemotherapy in the Community Setting
• Chemotherapy Safety in the Home - A Patient Guide to Oral Chemotherapy
• Metro Syringe compatibilities
• NIKI Clinical Practice Guidelines
• EMR PCC Opioid Conversion Guide to Practice

A range of resources for palliative care health professionals about standards for providing quality care and aged care.

Palliative care is an approach to  care which aims to improve quality of life by providing the best possible symptom control and support for patients and carers. It aims to minimise suffering associated with cancer and other serious illnesses.

Information and links are provided for consumers, their family and friends.

A range of tools and a framework to assist in the collection of data for the evaluation of a variety of palliative care projects, so that such palliative care initiatives can be monitored and their impacts measured from an evaluation perspective.

Respecting Patient Choices® (RPC) Program provides a quality-assured system that can be implemented to assist health professionals to discuss, record and document a patient’s preferences for their future healthcare, in preparation for a time when they might not be able to competently contribute to their end-of-life decisions; frequently (but not always) about end-of-life medical treatment.

Training in the RPC Program enables doctors, nurses and allied health workers to discuss advance care planning helpfully and sensitively with patients and their families.

This site provides information, materials and educational resources to assist health professionals to implement advanced care planning processes and support their patients at end of life.

Acute Pain Management: Scientific Evidence, 3rd Edition covers a wide range of clinical topics. The purpose of the document is, as with the first two editions, to combine a review of the best available evidence for acute pain management with current clinical and expert practice, rather than to formulate specific clinical practice recommendations. Accordingly, the document aims to summarise the substantial amount of evidence currently available for the management of acute pain in a concise and easily readable form to assist the practising clinician.

Chapter Nine focuses on pain management for acute cancer pain.

A presentation explaining the benefits of a palliative approach to bowel care to manage the side effects of cancert treatments.

The design and development of the Cancer Pain Management in Children website and its contents were funded by a grant from the Texas Cancer Council as a resource, focused on pain management, for health professionals who care for children with cancer. Pain is frequently a significant acute and chronic symptom of these children and is often under treated. A better understanding of the nature of pain, new interventions, agents, and methods of pain medication delivery are essential components to improving a child's care and quality of life.

Information available on the site includes:

• What is Pain?
• Etiology of Pain in Children
• Barriers to Effective Pain Management
• Assessment of Pain
• Pharmacologic Pain Management
• Procedure-related Pain Management
• Non-pharmacological pain interventions
• End of Life issues for children

An active glossary and Pain Management in Children handbook are also accessible on the site.

This resource provides interactive tools for healthcare providers to assist with managing pain in cancer patients. These tools include a calculator for converting drug dosages, and an interactive dermatome map.

HACPM also provides multimedia instructional tools. These include video clips of pain experts and cancer patients addressing issues regarding pain management in patients with cancer. Also included are animated tutorials on the neurological processes involved in pain.

A selection of available tools for measuring pain and assessing and tracking the level of symptoms that can be downloaded as a PDF, including:

• Edmonton Symptom Assessment Scale (ESAS)
• Fatigue Inventory
• McGill Pain Inventory
• Memorial Symptom Assessment Scale (MSAS)
• Needs at the End-of-life Screening Tool (NEST)
• Palliative Care Outcome Scale (POS)
• Wong-Baker FACES Pain Rating Scale

Designed for primary care physicians, nurses and assistants, Upon completion of the activity, the primary carer should be able to:

1. Define the major clinical types of pain
2. Outline a systematic approach to  pain assessment and evaluating outcomes
3. List and discuss several categories of medications useful for pain
   management
4. Describe the models of therapy used
   by psychologists for chronic pain
5. Summarize various physical and
   procedural interventions for
   managing pain
6. Define potential adverse outcome
   issues of which clinicians should be
   aware. 

A self assessment and evaluation are included.

Course expires in July 2011

The Palliative care Outcome Scale (POS) is a short, easy-to-use clinical outcome measure based on patient questionnaires designed to help clinical practitioners meet people's palliative care needs. Further information relating to the research and development of the tool is available: http://www.csi.kcl.ac.uk/pos.html

The resources on the site allow you to find out more about the POS, download the scales, register your interest and, if you wish, order a copy of the user guide. The POS user guide provides additional information on tailoring the POS to your organisational settings and analysing the data you collect.

Evidence related to the use of the tool in lung cancer patients is available in the following MedScape report of the European Respiratory Society 19th Annual Congress in 2009: http://www.medscape.com/viewarticle/708995

Advance Care Planning (ACP) is Part 1 of the Respecting Patient Choices (RPC) education course geared to provide a broad introduction to ACP.

The course consists of six modules that take approximately one hour to complete and cover basic definitions, legal aspects, considerations regarding end of life decision-making and communication, the actual process of holding advance care planning conversations, as well as systemic matters that underpin ACP.

Part 2 is a full day workshop that focuses on communication skills giving you the opportunity to train and build your advance care planning skills in an applied setting to assist you in leading end of life decision-making discussions. 

Development of "The clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers" was supported by a Strategic Research Grant from the National Health and Medical Research Council on Discussing prognosis and end-of-life issues in palliative care current practice and development of an evidence based training program.

Prognostic and end-of-life communication is a vital skill for health care professionals caring for patients with progressive life-limiting illnesses, and their families. Expert opinion varies, and high-quality evidence on how best to discuss these issues with such patients and their caregivers is limited. These guidelines were developed to address these issues.

The guidelines were developed through the following methods:

• Systematic literature review of the best available evidence on discussion of prognosis and end-of-life issues
• Review of previous relevant guidelines and expert opinions in the literature
• Refining of draft guidelines by an expert advisory panel.

A document detailing the core competences and principles determined in the UK that underpin all levels of practice for health care professionals whose work includes care and support for people approaching, and at, the end of their lives, whether their primary involvement is healthcare related or social care and support.

EPERC provides resource to End of Life/Palliative healthcare professionals through support from the Medical College of Wisconsin. The site is intended to support individuals involved in the design, implementation, and/or evaluation of End-of-Life/Palliative education for physicians, nurses and other health care professionals.

Major content areas in EOL/Palliative education include:

• pain
• non-pain symptoms
• communications skills
• ethics
• terminal care
• clinical interventions used near the end-of-life

Education materials are arranged by format including:

• Behaviorally Anchored Rating Forms
• Cases
• Evaluation Forms
• Multiple Choice Exams
• Pocket Instructional Aids
• Slide Presentations
• Standardized Patient Materials
• Web sites

The Texas Children's Cancer Centre End-of-Life Care for Children website contains information and resources to assist health professionals to care for children and their families at the end-of-life.

Information is included regarding:

• Difficult decisions
• Supporting Family Caregivers
• Physical Care of the Dying Child
• Psychosocial Care of the Family
• Helping Professionals Care for Dying Children

Resources include video interviews and a downloadable handbook

Many patients with advanced cancer and their caregivers have questions about what thet might expect during the last few months of life. 

This site provides information on what to expect when you or someone you care for are nearing the end of life, as well as information on hospice care and on coping with the loss of a loved one.

A brief guide to assist health professionals who have to deliver bad news to patients or discuss difficult topics, such as end of life issues.

Comprehensive, authoritative, evidence-based information regarding death and dyingm including choices, legal issues, pallitive care, treatment and advanced directives. Multimedia resources including anatomical drawings are available on the site. 

The End of Life Curriculum Project is a joint project of the US Veterans Administration Palliative Care Network and SUMMIT at Stanford University School of Medicine and is funded by the National Institutes of Health.

The program is designed as a comprehensive, modular self study resource to teach medical students and health professionals about End of Life (EOL) and palliative care issues and develop relevant knowledge, attitudes and communication skills.

The course includes the following modules, together with a detailed introduction and learning objectives; as well as a post-test and further resources:

Overview of Palliative Care

Dyspnea

Home Hospice

Opioid Conversion

Prognostication

Transition to Death

Palliative Sedation

Communication

Bereavement

An article was published regarding the success of the pilot program with Stanford University medical students:

"The module provides students with opportunities to practice communication skills and to assess their abilities to use them in a clinical situation. The module exposes students to multiple facets of EOL and palliative care that are not formally explored in our medical school's curriculum. Topics include non-medical resources for dying patients and their families, the use of hospice, patient-centered pain and symptom management, and the management of psychosocial distress. A clinical case from the literature serves as the cornerstone for discussion of these topics. Finally, the module emphasizes that clinical proficiency in EOL and palliative care requires mastery of concrete clinical skills and is not, as one of our mentors teaches, simply the result of good intentions."

Magnani, Jared W. MS; Minor, Melissa A.; Aldrich, Jon Matthew (2002), "Care at the End of Life: A Novel Curriculum Module Implemented by Medical Students", Academic Medicine: Special Theme: End-of-life Care: Education and Practice; April, 77(4):292-298. Click here for full article.

Intended users include members of a palliative care team, including medical students, residents, fellows, physicians, social workers, psychologists, and chaplains.

This case study recounts the experience of Jane, a 36-year-old female diagnosed with ovarian cancer. This case study aims to facilitate the development of competencies that reflect the role of the Specialist Cancer Nurse (SCN) in preventing, assessing and managing disease and treatment-related care for people affected by ovarian cancer across the cancer journey.

The case study contains four sections:

• Find the condition early
• Have the best treatment and support during active treatment
• Have the best treatment and support between and after active treatment
• Have the best care at the end of life.

EPEC™-O (Education in Palliative and End-of-Life Care for Oncology) is a comprehensive multimedia curriculum available in CD-ROM format for health professionals caring for persons with cancer.

The learning objectives include:

• Describe the scope of knowledge, attitudes, and skills that comprise the core palliative care competencies needed throughout the course of comprehensive cancer care.
• Incorporate the described treatment recommendations and approaches into clinical practice.

The curriculum is available on CD-ROM. A DVD containing video vignettes is also included. The curriculum can be used as a self-study or for in-person training.

The Self-Study Section contains 3 plenary sessions and 15 content modules with self-assessment questions, self-reflection tasks, instructional text, associated PowerPoint slides, and interspersed video vignettes, with accompanying resources for the lay public and health professionals, and internet-linked reference citations.

The Materials-for-Trainers Section contains participant handouts, trainer's instructional guides, modifiable PowerPoint slides, conference evaluation forms, participant pre-post test questions, and more.

Many learning resources deal with pain in patients with cancer, but few explain how to treat other common symptoms such as breathlessness and constipation. There is a small section on pain (on using opioids in the community) however, this free, peer reviewed module mainly concentrates on other symptoms, along with the common palliative care emergencies.

After completing this module you should:

• Have a better understanding of how best to use opioids in the community (including how to switch drugs and routes of administration)
• Be more confident recognising and treating common events in the last years of life, such as:
  • Breathlessness
  • Constipation
  • Spinal cord compression
  • Superior vena cava obstruction
  • Hypercalcaemia
• Be more aware of sources of support for patients
• Know when to refer your patient to a specialist.

Based in Victoria, Banksia Palliative Care's Learning Centre offers a broad range of palliative care educational opportunities.

Workshops and sessions for all staff are available regarding:

• Pain management
• Symptom management
• Complementary therapies
• Loss and Grief
• Communication skills
• Staff support 
• The palliative approach
• Advance care planning
• Ethical issues

An extensive Palliative Care Resource Nurse Course, credited by Melbourne University for Registered Nurses Division One, is offered as well as  one and two day courses covering a variety of palliative care topic areas including endorsed injectables, analgesics and calculations, nausea and vomiting, dyspnoea, massage and music therapy.

Banksia Learning Centre also offers National Training Units of Competency  in:

• Delivery of Care Services Using a Palliative Approach
• Plan for and Provide Care Services Using a Palliative Approach

The brochure for 2010/2011 is available here.

The overall aim of this program is to improve the quality and accessibility of palliative care services to all people with life-limiting conditions and their families by providing primary carers with an ideal opportunity to learn from experienced specialist staff to enhance skills, knowledge and experience in the palliative approach.

PEPA provides primary carers (nurses and allied health; GPs and rural medical staff; Aboriginal and Torres Strait Islander Health Workers; and other health professionals) with an opportunity to develop their knowledge and skills in the palliative approach to care through:

• funded clinical workforce placements or workshops
• integration of learning into your workplace
• establishing networks of support.

The PEPA learning experience helps primary carers to:

• gain a clear understanding of principles of good palliative care identify the needs of patients with life-limiting conditions
• understand the role of their discipline in managing common problems faced by palliative care patients
• recognise their own knowledge base/scope of practice in regard to optimal palliative care provision
• identify personal coping strategies for effective management of personal issues related to working in this area.

Education and training resources that can be used by aged care staff to familiarise themselves and other staff in their aged care homes about the Guidelines for a palliative approach in residential aged care.

Resources include:

• Guidelines for a palliative approach in residential aged care: Enhanced edition 
• Training modules for a palliative approach in residential aged care
• Training resources for the Guidelines for a palliative approach in residential aged care
• RACPAN newsletters

There is also a self-directed learning package to educate staff about a palliative approach in residential aged care, including:

• Manual (large PDF document 2.35MB)
• Guidelines for a Palliative Approach in Residential Aged Care
• Case scenario on a palliative approach (12 minute video)
  • 100MB high quality download for professional presentations (very large file)
  • View video on Google Video (recommended)
• PowerPoint presentations that you can use when informing others in your aged care home about the palliative approach and the Guidelines
  • Presentation 1 - Residential Network
  • Presentation 2 - Trainers
  • Presentation 3 - Members of AcLan

PCA produced teaching resources for the following 2 units of competency about a palliative approach for Certificate III and Certificate IV qualifications:

• CHCPA01A Deliver care services using a palliative approach
• CHCPA02A Plan for and provide care services using a palliative approach

These resources are available for AUD $225 (ex GST).

The teaching resources contain all the information that a trainer will need to deliver a competency unit. This includes PowerPoint presentations with notes, learning activites, assesment tasks and learners resources that can be photocopied for students.

Bereavement Care Centre offers a variety of skills focused courses in bereavement counselling, developed around a Core Course of three days, including:

• Core Course - Bereavement Counselling
• Working With Bereaved/Dying Adults
  Working With Bereaved Children
• Summer School in Bereavement Counselling
  Winter School in Bereavement Counselling
• Post-Graduate Diploma - Counselling Bereaved Children
  Certificate Of Merit
• Post Graduate Diploma In Clinical Supervision
• Bereavement Support Workers Course - Working with Bereaved Children
• Clinical Supervision